An infected enlarging abdominal aortic aneurysm after acute cholecystitis. 2014

Sang Y Hwang, and James M F Clarke, and Tjun Y Tang
Department of Vascular Surgery, Prince of Wales Hospital, Randwick, NSW, Australia; Prince of Wales Hospital Clinical School, University of New South Wales, Australia. Electronic address: syhwang15@gmail.com.

BACKGROUND An abdominal aortic aneurysm (AAA) infection is rare and can be difficult to manage, with high morbidity and mortality. We present a patient who suffered an infected AAA after undergoing a laparoscopic cholecystectomy and discuss the surgical management options. METHODS A 69-year-old male presents with a rapidly enlarging AAA 4 weeks following laparoscopic cholecystectomy. He was managed with open debridement, washout and repair of the aneurysm, but suffered ongoing sequelae of Escherichia coli sepsis. CONCLUSIONS The options for surgical management of infected AAA include open, endovascular and combined approaches. Recent papers report successful use of endovascular repair of infected AAAs but this is an ongoing area of research. CONCLUSIONS Infection of an AAA is associated with high mortality and long-term morbidity and requires optimal treatment. Surgical options include open debridement and repair, endovascular aneurysm repair (EVAR) or a combined approach.

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